Autism and Associated Medical Conditions

Guest post by epidemiologist Laura Schieve, Ph.D., of the National Center on Birth Defects and Developmental Disabilities, at the Centers for Disease Control and Prevention.

In recent years, several reports have suggested that children with autism or other learning or behavioral developmental disabilities are more likely than typically developing children to have health conditions such as respiratory or gastrointestinal illnesses.

However the studies behind these reports were often small and showed inconsistent findings. Some of their methods had limitations. One of the biggest problems was that they didn’t adequately compare children with different types of developmental disabilities. Because of these limitations, many public health professionals and healthcare providers have been skeptical about whether children with autism or other behavioral developmental disabilities truly faced an elevated risk of other medical problems.

My colleagues and I wanted to help paint a clearer picture of this important public health issue. Our study, recently published in the journal Research in Developmental Disabilities, compared the medical conditions and healthcare needs of children with developmental disabilities with those of children without developmental disabilities. We also compared children with autism with those who had other developmental disabilities.

We assessed children included in the National Health Interview Surveys from 2006 to 2010. Households throughout the United States are randomly selected to participate in this annual survey. In households with children, one child is randomly selected to participate. Each child’s parent or other primary caregiver is interviewed in-person about the child’s health and development. Interviewers asked whether a doctor or other healthcare provider has ever told them the child has certain conditions including autism and several other developmental disabilities. We also ask if the child has a health condition such as asthma or has experienced other symptoms such as frequent diarrhea or colitis in the past year.

We included more than 41,000 children aged 3 to 17 years in the study. Of these, 5,469 had one or more of the following five developmental disabilities: autism, intellectual disability, attention deficit and hyperactivity disorder (ADHD), learning disability or other developmental delay.

As a group, these children had higher than expected rates of all of the medical conditions we studied. More specifically, they were:

* 1.8 times more likely than children without developmental disabilities to have ever had an asthma diagnosis,

* 1.6 times more likely to have had eczema or a skin allergy during the past year,

* 1.8 times more likely to have had a food allergy during the past year,

* 2.1 times more likely to have had three or more ear infections during the past year,

* 2.2 times more likely to have had frequent severe headaches or migraines during the past year, and

* 3.5 times more likely to have had frequent diarrhea or colitis during the past year.

These increased rates of health conditions held true even for children diagnosed with ADHD or learning disability, but not diagnosed with autism or intellectual disability.

However, one finding stood out in particular when we compared the developmental disability groups to each other: Children with autism were twice as likely as children with ADHD, learning disability or other developmental delay to have had frequent diarrhea or colitis during the past year. They were seven times more likely to have experienced these gastrointestinal problems than were children without any developmental disability.

This detailed assessment demonstrates that children with autism or many other types of developmental disabilities do, in fact, face an increased risk for many common health conditions. This, in turn, provides evidence that children with developmental disabilities require increased health services and specialist services, both for their core functional deficits and for health problems beyond their core developmental disabilities.

May this research help Autism Speaks accept the tangible fact that Food Choices matter greatly for ASD – and help them guide education on effective dietary intervention.

“higher than expected rates of all of the medical conditions”

“seven times more likely to have experienced these gastrointestinal problems”

These findings unquestionably validate biomedical approaches to ASD. No longer should parents be laughed at when they suggest addressing their child’s physical symptoms with tactics as innocuous as the omission of a food substance.

Let NOW be the time we stop agreeing to lie about what’s going on with this disorder and embrace one single shift in perspective – that ASD is a full body disorder that can be treated (and that attention to diet is of foremost concern). Dr. Martha Herbert’s new book, The Autism Revolution, will also greatly help advance this acceptance (that ARI and others have championed for years).

Attention to diet is imperative – let’s work together to help parents and professionals to be most effective at this foundational step to helping children.

I suggest that even more important than the omission of a food would be the addition of some foods to ensure that the diet is actually adequate for proper brain development and other aspects of development. Dietary practices that fall short on adequacy will result in numerous problems generally referred to as chronic disorders. The solution is for parents to better understand the nutritional needs of the body and to find ways to get the child to consume enough for his/her good health.

hello, im probably saying this wrong but here goes nothing. I have a friend that has a son who has erpsberger, i understand its a form of autism. hes 21 but in a 12 year old mind. She is working hard to develop so he can be a self reliant and contribute to society. great kid, just sometimes falls to the youth mind set. Any suggestions

“We included more than 41,000 children aged 3 to 17 years in the study. Of these, 5,469 had one or more of the following five developmental disabilities: autism, intellectual disability, attention deficit and hyperactivity disorder (ADHD), learning disability or other developmental delay.

As a group, these children had higher than expected rates of all of the medical conditions we studied. More specifically, they were:” (SO, 5K+ HAD THE LIST OF DISABILITIES IN THE PARAGRAPH ABOVE).

LIST OF CO-MORBIDITIES (I’M NOT LISTING)

“These increased rates of health conditions held true even for children diagnosed with ADHD or learning disability, but not diagnosed with autism or intellectual disability.” (SO KIDS WITH ASD/INTELLECTUAL DISABILITY DID NOT SHOW CO-MORBIDITIES?)

“However, one finding stood out in particular when we compared the developmental disability groups to each other: Children with autism were twice as likely as children with ADHD, learning disability or other developmental delay to have had frequent diarrhea or colitis during the past year. They were seven times more likely to have experienced these gastrointestinal problems than were children without any developmental disability.” (THEN KIDS WITH ASD DO SHOW MORE CO-MORBIDITIES?)

I’M REALLY, TRULY CONFUSED. PLEASE EXPLAIN THE NUMBERS MORE CLEARLY.

I’M CONCERNED THAT DOCTORS AT OUR LOCAL HOSPITAL WILL USE THIS TO CONTINUE TO DISMISS OUR CONCERNS.

Autism is medical. There is growing scientific evidence that there is a physiological basis for autism. Here are some recent studies. Researchers from Johns Hopkins School of Mediicine, Department of Neuro-immuno pathology discovered inflammation associated with microglia activation in brains of children with autism. UC Davis MIND Institute researchers discovered that many children with autism they examined have an underlying mitochondrial problem that results in deficits in cellular energy metabolism. Researchers at Columbia Unviersity found that children with autism have abnormal gut bacteria not present in “normal” controls. We need to expand the diagnostic process in autism to include blood tests and GI (gut environment) screening for these related underlying conditions because these screenings can greatly affect the course of a child’s medical treament.

I’m so glad to see this article and study! As a nutritionist specializing in autism, I have seen so many children with gastrointestinal problems. They can even go unaddressed by their medical doctor who brushes it off as “just autism.” These children need medical support and this study shows that! Additionally, this study supports what many parents have witnessed – dietary intervention can be helpful for ADHD and autism. When there are GI and immune system problems (as shown in the study), eliminating inflammatory foods such wheat and dairy can be very helpful for many children. Additionally, adding nutrients and fatty acids can help with underlying deficiencies that can cause or exacerbate eczema and other conditions. Here’s a short article with scientific references on “why diet helps.” http://nourishinghope.com/2011/03/food-matters-for-autism-the-science-and-why-of-special-diets/

You sound like the kind of person I may be looking for to help me answer a few questions about autism and GI disorders. I will read the link you provided; it may tell me what I want to know, but is there a way to contact you? I live in an area with relatively limited specialty medical services.

Thank you for this wonderful post!
It is such a breathe of fresh air after all the DMSV psychologists ignore biomedical issues w/in the autism population completely. My son has no real social problems (their #1 barometer of severity) but a myriad of biomedical issues.

Sarah is right- for so many of us autism is medical!

After a dozen useless trips to see neurologists all over the country- looking for that “rare gene” causing Christian’s autism (guess what they never found it) it was Julie Matthews a nutritionist who helped my son.

I am encouraged to see this post because I have been VERY concerned that Autism Speaks’ ATN centers are doing a very poor job regarding these issues. Dr. Susan Hyman’s ATN dietary intervention research is useless, dated and poorly done. Yet she is their standard bearer on the topic. It is very distressing. ATN also refers out all ASD families seeking ASD/nutritional expert help. That is the kind of help they should be providing. ATNs receive tens of millions of our tax $ to help our families- they can afford to train some people who studied w/ Julie. Please get going and do that.

It is wonderful to hear that there are some studies showing what parents of autisic children have known for years: their bodies work a little differently (just like their brains!).

I have two high-functioning autistic children, both of whom have also been diagnosed with biopsy-proven Celiac disease. The Celiac diagnosis followed the autism diagnosis, and I had not previously tried making dietary changes with my children. Following diagnosis, both children went gluten free and I noticed improvements in their autistic behaviors, as well.

I, too, have been diagnosed with Celiac disease, but I do not have autistic tendencies (their dad is another story). I have often suspected that there may be a link between the autoimmune disorder and their autism, and it looks like research is on track to investigate the correlations. Is autism a “perfect storm” of genetic conditions that come together to present us with our autistic childred?

I still would like to see a study done to see if there is any relation to autism with arnold chiari malformation..i have it and it is being studied now to see if it is genetic or familial but also i have seen several in my support group who have a child who has autism, sometimes nonverbal who had the posterior fossa decompression surgery(brain & spinal surgery which i have had) and afterwards they became better and verbal and sometimes a lot better and not so ‘autistic”….i also have an adult son who has aspergers and i know that before my surgery, at times i myself felt “autistic” in the ways/symptoms i have read others who have autism feel like when they are able to exprss how it feels to them having autism. It’s just a thought that keeps going through me. I would like to see a study on it. And my son who has aspergers most definitely has bowel/intestinal issues, skin allergies , eczema, he had a seizure when he was 6 and the list goes on.. he also is typical in that he doesnt like vegetables or fruit, only starches, white foods, pizza, mac & cheese and cheeseburgers(plain of course!) and tan/bland colored foods..and im pretty sure diet has a lot to do with the tummy habits too? anyhow just my 2 cents..

It’s a Catch 22 situation. How can one identify a co-morbid health conditon if the physician isn’t even going to look and how are health conmdtion going to be accurately reflected in a study if the doctors refuse to look let alone diagnose in the first place?

Many autism parents who are seeking medical help for their children for related health problem are being brushed off. As Julie Matthews said parents get brushed off as “that’s just autism”. I call it the wall effect. We feel blocked and that is very frustrating.

That’s just autism” is common for autism parents to hear. I’ve experienced this personally when I sought medical help for my son or asked for futher testing. For example, since it’s been shown that children with autism often have an underlying mitochondrial problem, I asked my sons neurologist if my son may have a mitochondrial test. He wouldn’t even consider testing my son. When I asked took my son to an ENT because of sound sensivity, I was told “well, that’s his autism”…and that’s when the wall goes up.

Would it be nice if the mainstream medical profession finally realised and admitted that ‘autism’ is not some sort of mysterious intervention by the Creator, but is actually nothing more than surface manifestation of biomedical pathology.

The world IS round, let us now please move on to pinning down treatments!!

Please consider looking into an alternative treatment for your kids. Children with ASD have many sensitivities and allergies. We are taking our kids to a Naturopathic Doctor and having them treated with NAET. Nambudripad’s Allergy Elimination Technique. We have been doing this since August 2011. As a result so far, they have much fewer colds, no ear ifections, and their GERD has decreased on a scale of 1 – 10 ,from an 8 to a 2. Look up http://www.naetautismtreatmentcenter.com . The full course of treatment takes about 2 years. So far we are 8 months into it.